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Left upper lobectomy is a risk factor for cerebral infarction after pulmonary resection: a multicentre, retrospective, case–control study in Japan

Surgery Today volume 50, pages 1383–1392 (2020)Cite this article

A Correction to this article was published on 03 September 2020

This article has been updated

Abstract

Purpose

The anatomical site of resected lobes may influence postoperative cerebral infarction. The objective of the current study was to determine if left upper pulmonary lobectomy is a risk factor for postoperative cerebral infarction.

Methods

This was a retrospective case–control study in patients undergoing pulmonary lobectomy from 2004 to 2013 in Japan. We retrospectively identified 610 patients from 153 institutions who had developed postoperative cerebral infarction following pulmonary lobectomy. The control group consisted of 773 patients who underwent lobectomy without cerebral infarction during a randomly selected single month in 2009 at the same institutions.

Results

Factors associated with cerebral infarction were age [10-year intervals, odds ratio (OR): 1.46; 95% confidence interval (CI): 1.23–1.73; p < 0.001], male sex (OR 1.92; 95% CI 1.29–2.86; p = 0.001), presence of comorbidities (OR 1.82; 95% CI 1.35–2.44; p < 0.001), perioperative anti-platelet or anti-coagulant drug use (OR 1.71; 95% CI 1.20–2.45; p = 0.003), and lobectomy. Subgroup analyses revealed that cerebral infarction was strongly associated with left upper lobectomy.

Conclusions

Our findings suggest that left upper lobectomy is associated with a higher risk of cerebral infarction than other types of lobectomy, particularly in the early postoperative period.

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Fig. 1
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Change history

  • 03 September 2020

    The original article can be found online.

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Acknowledgments

The authors are grateful to the members of the JACS office for their support with data management and to the members of each JACS institute included in this study for their assistance with data collection.

Funding

None.

Author information

Authors and Affiliations

  1. Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan

    Keitaro Matsumoto & Nagayasu Takeshi

  2. Clinical Research Center, Nagasaki University Hospital, Nagasaki, Japan

    Shuntaro Sato

  3. Toneyama Hospital, Toyonaka-shi, Osaka, Japan

    Meinoshin Okumura

  4. Division of Thoracic Surgery, Respiratory Disease Center, Seirei Mikatahara General Hospital, Hamamatsu, Japan

    Hiroshi Niwa

  5. Department of Cardiovascular and Thoracic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Yasuhiro Hida & Kichizo Kaga

  6. Department of Thoracic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan

    Hiroshi Date

  7. Department of Thoracic Surgery, The University of Tokyo Hospital, Tokyo, Japan

    Jun Nakajima

  8. Department of Thoracic Surgery, Nippon Medical School, Tokyo, Japan

    Jitsuo Usuda

  9. Department of Thoracic Surgery, Kumamoto University Hospital, Kumamoto, Japan

    Makoto Suzuki

  10. Division of Quality and Patient Safety, Chiba University Hospital, Chiba, Japan

    Takahiro Souma

  11. Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan

    Masanori Tsuchida

  12. Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan

    Yoshihiro Miyata

Authors
  1. Keitaro Matsumoto
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  2. Shuntaro Sato
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  3. Meinoshin Okumura
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  4. Hiroshi Niwa
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  5. Yasuhiro Hida
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  6. Kichizo Kaga
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  7. Hiroshi Date
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  8. Jun Nakajima
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  9. Jitsuo Usuda
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  10. Makoto Suzuki
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  11. Takahiro Souma
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  12. Masanori Tsuchida
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  13. Yoshihiro Miyata
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  14. Nagayasu Takeshi
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Consortia

Committee for Patient Safety, Quality Management of Japanese Association for Chest Surgery

Corresponding author

Correspondence to Nagayasu Takeshi.

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Matsumoto, K., Sato, S., Okumura, M. et al. Left upper lobectomy is a risk factor for cerebral infarction after pulmonary resection: a multicentre, retrospective, case–control study in Japan. Surg Today 50, 1383–1392 (2020). https://doi.org/10.1007/s00595-020-02032-4

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  • DOI: https://doi.org/10.1007/s00595-020-02032-4

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